title: [Acute leukemia of ambiguous lineage with monosomy 7 and Philadelphia chromosome].
abstract: A 67-year-old female was admitted with a diagnosis of acute leukemia. Immature blasts did not show cytoplasmic granules and were POX(-), ES(-), and PAS(+). Flow cytometry of leukemic cells demonstrated positivity for CD7, CD10, CD19, CD13, CD34, HLA-DR, and coexpression of CD7 and CD34, CD10 and HLA-DR, and CD19 and CD13. Cytogenetic analysis demonstrated -7 and t(9;22)(q34;q11.2), and genomic studies demonstrated minor BCR/ABL chimeric mRNA and rearrangements of IgH and TCR. These findings indicated the clonal proliferation of leukemic blasts that expressed a mixed phenotype. Acute leukemia of ambiguous lineage was diagnosed, although the significance of the specificity of lineage markers remains unclear. The differential diagnosis included CML and B-ALL. The patient was treated according to Ph+ALL. However, the hematological response was poor, with persistent residual blasts and severe pancytopenia. The subsequent administration of imatinib mesylate led to a complication of heart failure, and the patient died on the 19th hospital day.
authors.affiliation: Department of Medicine, Yamaguchi Prefectural Medical Center.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Nakazora
authors.forename: Munehiro
authors.initials: M
authors.lastname: Suzukawa
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tominaga
authors.forename: Kenji
authors.initials: K
authors.lastname: Shinohara
mesh_terms: D000208:Acute Disease; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001549:Benzamides; D002872:Chromosome Deletion; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D000068877:Imatinib Mesylate; D007938:Leukemia / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology / Q000628:therapy; D010677:Philadelphia Chromosome; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate